Pengaruh Preventif Multimodal Analgesia Terhadap Dinamika Kadar Il - 1β, Intensitas Nyeri Pada Pascabedah Laparotomi Ginekologi

Tujuan: Penelitian ini bertujuan untuk membandingkan kadar IL-1β, skala NRS, padakelompok yang mendapatkan epidural bupivakain 0,125% kombinasi parecoxib 40 mgdengan kelompok yang mendapatkan epidural bupivakain 0,125% yang digunakansebagai multimodal preventif analgesia pascabedah laparotomi ginekologi.
Metode: Penelitian eksperimental dilakukan secara acak pada 50 pasien denganstatus fisik (ASA PS) II yang akan menjalani prosedur laparotomi ginekologi dengananestesi epidural. Subyek penelitian dibagi dalam dua kelompok perlakuan, yaknikelompok pertama dengan kombinasi parecoxib 40 mg (n=25) dan kelompok keduadengan kombinasi plasebo NaCl 0,9% (n=25). Kedua kelompok tersebut mendapatkananestesi epidural selama operasi dan sebagai analgesia pascabedah. Pengambilansampel darah pasien dilakukan 35 menit sebelum pembedahan untuk pengukurankadar IL-1 β, selanjutnya dilakukan pada 2 jam dan 24 jam pascabedah. Analisisstatistik menggunakan uji Mann-Whitney U dan Levane test.
Hasil: Rerata kadar IL-1β prabedah pada kelompok parecoxib 1,05±1,25 pg/ml, 1,24± 1,54 pg/ml untuk 2 jam pascabedah dan 1,82 ± 2,16 pg/ml pada 24 jam pascabedah.Kelompok kontrol, kadar IL-1β prabedah 1,65±1,69 pg/ml, 2,55±2,77 pg/ml untuk 2jam pasca bedah pg/ml, dan 1,96±1,97 pg/ml pada 24 jam pascabedah. Tidak adaperbedaan bermakna rerata skor NRS diam dan bergerak 2 jam, 12 jam, dan 24 jampascabedah diantara kedua kelompok sampel (p>0,05).
Kesimpulan: Kombinasi epidural bupivakain 0,125% dengan parecoxib 40 mg dapatmenurunkan kadar IL-1β pada 2 jam pascabedah.
Article Metrics:
- Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperatif pain experience: result from a national survey suggest postoperatif continues to be undermanage. Anesth Analg. 2003; 97(2) ):534-40
- Reuben S, Buvanendran A. The role of preventive multimodal analgesia and impact on patient outcome. In: Sinatra RS, Leon-Casasola OAd, Ginsberg B, Viscusi ER, McQuay H, editors. Acute pain management. 1st ed. 2009; New York: Cambridge University Press. p. 172-83
- Ashburn MA, Caplan RA, Carr DB. Practice guidelines for acute pain management in the perioperative setting: an updated reported by the American Society of Anesthesiologiest task force on acute pain management. Anesthesiology. 2004; 100:1573-81
- Ahmad M.R. Peran analgesia epidural preemtif terhadap intensitas nyeri, respon hemodinamik serta dinamika kadar sitokin proinflamasi dan antiinflamasi pada pasca bedah ekstremitas bawah [Disertasi]. 2012; Makassar: Universitas Hasanuddin
- Samad TA, Sapirstein AA, Woolf CJ. Prostanoid and pain : unraveling mechanism and revealing therapetic targets. Trens Mol Med. 2012; 8:390-96
- Beilin B, Bessler H, Mayburd E, Smirnov G, Dekel A. Effect of preemtive analgesia on pain and cytokine production in postoperative period. Am Societ Anesth. 2003; 98:151-55
- Brandsborg B, Dueholm M, Jensen TS. Nikolajsen L. Mechanosensitivity before and after hysterecyomy: a prospective study on the prediction of acute and chronic postoperative pain. Br J Anest. 2011; 9:1-8
- Barton SF, Langeland FF, Snabes MC, LeComte D, Kuss ME. Efficacy and safety of intravenous parecoxib sodium in relieving acute postperative pain following gynecologic laparotomy surgery. Anesthesiology. 2002; 97:306-14
- Ng A, Smith G, Davidson AC. Analgesic effects of parecoxib following total abdominal hysterectomi.Br J Anaesth. 2003; 90(6):746-9
- Malan TP, Gordon S, Hubbard R, Snabes M. The cyclooxygenase-2 spesific inhibitor is effective as 12 mg of morphine administered intramuscularly for treating pain after gynecologic laparotomy. Anest Analg. 2005; 100:454-60
- Naito Y, Tamai S, Shingu K, Matsui T, Segawa H. Responses of plasma adrenocotricotropic hormone, cortisol, and cytokines during and afterupper abdominal surgery. Anesthesiology. 1992; 77(3):426-31
- Aida S, Baba H, Yamakura T, Taga K, Fukuda S , Shimoji K. The effectiveness of preemtive analgesia variies according to the type of surgery: a randomized, double-blind study. Anesth Analg. 1999; 89:711-16
Last update: 2021-03-04 08:21:25
Last update: 2021-03-04 08:21:25
The Authors submitting a manuscript do so on the understanding that if accepted for publication, copyright of the article shall be assigned to JAI (Jurnal Anestesiologi Indonesia) and Department of Anesthesiology and Intensive Theraphy, Faculty of Medicine, Diponegoro University as publisher of the journal. Copyright encompasses exclusive rights to reproduce and deliver the article in all form and media, including reprints, photographs, microfilms, and any other similar reproductions, as well as translations.
JAI (Jurnal Anestesiologi Indonesia) and Department of Anesthesiology and Intensive Theraphy, Faculty of Medicine, Diponegoro University and the Editors make every effort to ensure that no wrong or misleading data, opinions or statements be published in the journal. In any way, the contents of the articles and advertisements published in JAI (Jurnal Anestesiologi Indonesia) are the sole and exclusive responsibility of their respective authors and advertisers.
The Copyright Transfer Form can be downloaded here:[Copyright Transfer Form JAI]. The copyright form should be signed originally and send to the Editorial Office in the form of original mail, scanned document:
Mochamat (Editor-in-Chief)
Editorial Office of JAI (Jurnal Anestesiologi Indonesia)
Department of Anesthesiology and Intensive Theraphy, Faculty of Medicine, Diponegoro University/ Dr. Kariadi General Hospital Medical Center (RSUP Dr. Kariadi)
Jl. Dr. Soetomo No. 16 Semarang, Central Java, Indonesia, 50231
Telp. : (024) 8444346
Email : janestesiolgo@gmail.com